Julia Knight

Would the NHS be so concerned?

Is Thai healthcare about care or cash?

I am pregnant with my second child and despite all the protests about how much I hated it the first time around and 'would never ever, not ever do it again' have found myself in the club.

In the expat club of expensive hospitals, anti-natal check ups and visits - all the things and services one takes for granted in the UK- you pay for here.

Luckily for us, we have great medical insurance that covers most of the costs because as we have found out, it isn't cheap.

But cost has nothing to do with it when you are expecting, because you can't put a price on a baby... well they do here and it does leave me wondering whether or not it is all necessary.

I have this overwhelming feeling the NHS would have told me to man-up and although they would have checked for all the usual things, there wouldn't have been an urgent rush to scan, test and diagnose.

But then as I found out with my first baby, the NHS midwifery and maternal services are creaking with sciatica because of the poor ratio of staff to patients. It is nowhere near the perfect, shiny corridors of Bangkok's finest medical hubs.

So we go, dutifully, along to each appointment and listen to the doctors, who have very little in the way of a 'bed side manner' and scare the be-Jesus out of you with worst case scenarios and directness. You can't just say 'no'- can you?

Pregnancy is a fearful time and with the stakes too high and the regrets too awful to contemplate. You just go with whatever it is that is suggested. Doctor do know best- don't they?

You do get a choice of doctor here and a choice of which hospital to go to, but as with everything else, experience and expense is different for everyone. Costs vary and having heard and read horror stories of hospitals adding on 'extras', we have cautiously made our decision.

There's a secret 'mummy club' on Facebook and even though some expat mummy worries belie the real world, it has proven to be a very useful source of information.

There is a clique who prefer Samitivej and have pledged allegiance to its hallowed Obs and Gyn wards and another set who wouldn't trust any other than Bummungrad.

Make your own mind up as you will but please don't judge me or be misguided into thinking I am expat whinging. I am not.

I recognise my fortune, my dilemma simply begs the question- is it me or my cash that's worthy of all the attention?

About me



Thailand healthcare is no different than most other countries. It's a business - and these days business is all about the 'up-sell' or the extra 'extended warranty' that you don't need.

Mercifully though, drugs and treatments are a lot cheaper here. I buy bottles of gout medicine and each tablet is 2 baht a piece. Fantastic!

One rule I have found (having lived in Bangkok, and now more rural climes) is that the emphasis on the 'up-sell' is proportional to your proximity to Bangkok (and a couple of other big cities.)

A few years ago, I had some visitors from Australia who had a young child. It had fallen sick with a common childhood ailment, whooping cough. This is easily treatable with antibiotics, but the very first thing the scared parents were offered when they walked through the door at the plush 'Hotel Hospital' in Bangkok was a tracheotomy!

If the big swanky hospitals have the services and the equipment then why not use them, eh?

There's also a cultural difference that westerners face when they have kids outside their own comfortable domains. Having children in Thailand isn't the massive hoopla and overly melodramatic circus that it is back home. You get a bun in the oven, when it 's cooked - out it comes, hopefully alive and healthy. Off you go home.

Expats may easily view this lack of emotional involvement as a lack of professional attention.

Being pregnant isn't the same as being sick. You don't need all the bloated attention from healthcare professionals unless there is a danger to you or the unborn infant. When my wife and I had a baby in the UK the service and attention was just perfect. No other country in the world could have provided better attention to detail or services.

Pre-natal classes, books, fun packs, home visits from nurses and social workers... you name it. And it didn't cost us a penny. Everyone wants to get involved. But I remember thinking that it was all a bit much. Overkill, really. After all - she was having a baby, not preparing for a liver transplant!

Good luck with your second child. If the first one was problem free then there's no reason to think that this one will be any different. Having a baby isn't something that needs to be diagnosed and treated, it's something to be enjoyed!

By Mark Newman, Thailand (25th March 2015)

Wakey Wakey!!

Of course it's about the cash!

Julia/Rob-all will go very well I am sure.
I had a Hernia operation in Samlong a couple of years back, and it was very well done. Caring/professional and thorough. Yes it cost Tb52,000 (all in). U.K. 'private' would have cost me Appx, £3000, so miles cheaper in Thailand.

I left Teaching in Samutprakarn, primarily over my school's insistence that I go on the Thai cultural course. That was after 3 years at the school and after having been coming to Thailand for some 20 years on holiday and a previous Teaching 'stint' in C/Mai for 1 year. AND I was reckoned to be very aware of Thai culture.
The Head of English at the school 'confided' in me that of Tb5,000 (at the time) for the course, the School got a Tb 2,000s a kick back. AND for the 3 days for the Course I would not be paid either by my Agency-total cost to me apx. Tb9,000!! EVERYTHING there is about the Dosh.
Surely you both know that?

By Neil Wragg (Ex Thailand and Vietnam Teacher.), U.K. (25th March 2015)

My gf is currently pregnant and I am having the same problem.

She was involved in a minor traffic accident last week. A motorbike hit the back rear of her stationary car. No airbags deployed, no car jolt.

I went to pick her up from the hospital, where the doctor showed us a perfectly healthy baby on ultrasound, with a perfectly healthy womb. He then added that such an accident would be very unlikely to cause any problems. However, then he delievered his killer line. But we dont know so best you stay in for observation.

Next day comes, and at 4pm were informed its so serious he wont be coming to observe. So a night in hospital, nurses, paid for on insurance. I wonder if he got a cut of that?

As my gf is then worried and in pain, we had to go to our Hospital, with our trusted Dr (nice hospital, not expat world). The Dr explained that as my gf was worried, she had tensed her stomach so much so her muscles had spasmed, causing pain. This was caused by the worry of the overnight stay, and the stress this caused. We are now into a week off work.

In my school, I had an ASEAN level swimmer, who "broke his arm". He was in a pot for 3 weeks, when he couldnt swim. There was nothing wrong with his arm, he was writing, moving his wrist, playing games of basketball.

The NHS would tell you to leave, but every week in the UK papers there is a story about an illness that was missed and someone dies. Its a fine line, and if the Hospital is private, you can see why they err on the side of safety. However, Im sure that being incentivised cash wise makes that decision a little bit easier.

By Rob, Bkk (25th March 2015)

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